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Stroke
About A stroke, sometimes called a "brain attack" or "cardiovascular accident" (CVA) occurs when there is a problem delivering oxygen-rich blood to the brain. When something interrupts the blood, brain tissue dies. Stroke is a medical emergency. It can cause permanent brain damage or even death if not promptly recognized and treated. It is the third leading cause of death and adult disability in the United States and industrialized Europe. Of every 5 deaths from stroke, 2 occur in men and 3 in women. Risk factors and Prevention Risk factors include advanced age, hypertension (high blood pressure), diabetes, high cholesterol, previous stroke, and cigarette smoking. People with high risk for stroke should talk to their doctor about prevention and medication. The risk of stroke decreases with lifestyle changes, chiefly smoking cessation. Making the scene safe, a medic's role Get out of crowds, noise, cold, and action to a safe, calm place (like a restaurant, print shop, post office, or hairdresser). Do initial assessment. Triage With any new signs and symptoms of a stroke, CALL 911 You might suspect a stroke with any of the following signs or symptoms: *Change in consciousness with no obvious MOI *"Umbles" without dehydration or heat/cold stress, or that do not get better after dehydration or heat/cold stress is alleviated **Slurred, garbled, or lost speech **Weakness in tongue (they cannot stick their tongue out or move it side to side) **Falls *Weakness or numbness in one side, or "paradoxical movement" (they cannot hold their arms out in front of them on the same level, they are smiling unevenly) *A person with stroke can be incontinent The symptoms of stroke depend on the person, the type of stroke, and the area of the brain affected.(1) If you suspect a stroke, physicians recommend a simple set of tasks to help the 911 operator guess where in the brain the problem is located. These are: *Ask the individual to smile. *Ask the individual to raise both arms and keep them raised. *Ask the individual to speak a simple sentence (coherently). For example, "It is sunny out today." If the person has difficulty performing any of these tasks, describe the person’s symptoms to the 911 operator. First aid treatment While waiting for the ambulance, you can do a few things. *Help the person keep calm, sit down, and rest. **Keep them talking to you **Calm and panic are both contagious *'Document' their symptoms and when it started **write your phone number at the top of your notes and let them carry the notes to the hospital *If the person loses consciousness or stops breathing, quickly and calmly do initial assessment and use the appropriate lifesaving skills. Aftercare For stroke support after the person comes home, call the American Stroke Association's Stroke Family "Warmline" at 1.800.553.6321. The American Stroke Association is a division of the American Heart Association and offers informational packages for professionals, stroke patients and family members of stroke sufferers. Visit ASA website at http://www.strokeassociation.org References #American Heart Assoc. (2006) Heart Attack, Stroke and Cardiac Arrest Warning Signs. http://www.americanheart.org/presenter.jhtml?identifier=3053 (Accessed 1/07) Notes Authors: Rob (STORM), EMT; Zil Goldstein, RN; Grace Keller, CHW Reviewer: Date Reviewed: This material is intended as a training supplement. Reading this material is no substitute for first aid / medical training with a qualified trainer. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. We encourage you to pursue ongoing education, reviewing and upgrading your skills-- for the safety of both yourself and anyone you may help.